Report overlooks NH’s dental gains

By Peter Welnak, John P. Ahern, Kristine Blackwelder and Roger Achong

Published: July 24, 2015

A recent article, citing a Pew Charitable Trusts-funded report by the Carsey School of Public Policy, raises questions about the status of our state’s oral health system. However, the article overlooks the tremendous progress made over the past decade.

For example, the article does not mention the fact that New Hampshire was recently named one of only five states in the nation to earn an “A” grade from Pew for the use of sealants in preventative oral health care for children. New Hampshire also ranks fourth best in the nation for the number of adults who had their teeth cleaned in the past year. While there will always be areas for improvement, the residents of New Hampshire need to know the achievements made in the oral health status of our population.

What we need to be asking is how to sustain our progress and continue the improvements to make high-quality and affordable dental care available to everyone.

First and foremost, we must work to ensure that everyone has a dental home, which provides comprehensive preventive and restorative dental care through a highly trained team of professionals that includes a dentist, dental hygienist and dental assistant. That dental team can be expanded as needed, as new certified public health hygienists and expanded function dental auxiliaries are trained, recruited and deployed, improving utilization of and efficiency in dental homes.

Restorative dental care, like most medical care, can be expensive. Thus, preventing the need for restorative care can save money.

New Hampshire has a comprehensive pediatric dental Medicaid benefit and program that has improved the oral health of New Hampshire’s children. However, we do not have a similar adult benefit, which means that Medicaid-eligible adults may only receive coverage when they experience extreme pain and/or require emergency extractions.

Experts agree that an adult Medicaid dental benefit would offer an affordable solution to this problem by fostering preventive care that saves teeth and costs, and may significantly reduce the number of people who visit hospital emergency rooms for oral disease-related issues.

Briefly mentioned in the report is the important fact that in most of the areas in which oral disease is higher than the state average, water supplies are not fluoridated. The NH Dental Society, the American Dental Association, the Centers for Disease Control and countless other organizations agree that fluoridation of public water systems is a proven and cost effective method of improving oral health. New Hampshire ranks last among the New England states in providing fluoridated water, with only 43 percent of those on public water systems offering fluoridation.

As oral health advocates and stakeholders, we must focus on educating everyone on the importance of joining a dental home and taking care of their oral health. There is no shortage of dental homes in New Hampshire, but there is an unfortunate lack of utilization.

In the North Country, for example, many dental offices struggle to fill appointments and resort to limiting hours of operation to sustain staff and overhead. Recently, a pediatric dental practice, seeking to establish a presence in the North Country, had to scale back due to the lack of patients.

Over the past 10 years, New Hampshire has developed a strong system of hundreds of private dental practices, dozens of public health dental clinics and mobile dental programs to help serve the diverse oral health needs of our state. We must continue to provide vocal, volunteer and financial support for these invaluable programs. We must also continue to educate ourselves and our neighbors on the value of good oral health practices. Without a focus on the main issues we face and the support to address those issues, New Hampshire’s standing as one of the healthiest states in the nation will be put at risk.

Peter Welnak of Keene, John P. Ahern of Derry, Kristine Blackwelder of Tilton and Roger Achong of Concord are all practicing dentists.

This article appears in the July 24 2015 issue of New Hampshire Business Review